Now, we’re entering uncharted territory. Most restrictions are being lifted, global travel has picked up, and orders for masks and boosters are few and far between. This fall and winter, with society largely reopening, scientists say they suspect we’ll see the return of cold and flu season — this time, with another respiratory pathogen in the mix. But exactly how the next few months will play out is hard to predict. “I think to be completely honest, nobody really has a good understanding of what the decline is going to look like,” said Dr. Michael Gardam, an infectious disease specialist and CEO of PEI Health. Experts note that several scenarios are possible. Pathogens such as SARS-CoV-2, influenza and RSV can take turns hitting the audience. Maybe we’ll see COVID-19 and flu infections gradually increase — it was called a “didemic” by some scientists. Or there’s a chance it’s just the flu coming back with a vengeance as other viruses make a comeback. Any of these three possibilities could be difficult for individuals to navigate, and each has the potential to put serious strain on Canada’s already strained health care system. “If I had to guess, I’d say we might have a moderately bad flu year,” Gardam said. “COVID — I have no idea.”
First clues from Australia’s flu season
While there’s no crystal ball to tell us exactly what’s next, Australia’s 2022 flu season offers some clues. There, the seasons are reversed from what people in North America experience, which usually provides an indication of what’s to come in Canada. Earlier this year marked the first major wave of the COVID-19 pandemic in Australiawith subsequent waves of rising and falling daily infections playing out like a rollercoaster until late summer. The country also suffered its worst flu season in years, and data from the Australian Department of Health and Aged Care show Infections were higher than the five-year average — with infections rising sharply and then falling earlier than usual. “Australia faces a real challenge [with flu] but we know at the same time that they’re having a challenge with a lot of COVID,” Gardam said, “and so it’s just hard to sort out what’s what.” It’s possible that the country’s recent flu season was an example of the flu virus switching with SARS-CoV-2, said Alyson Kelvin, a virologist and researcher at the Vaccine and Infectious Diseases Agency at the University of Saskatchewan. “But we’ll have to see a few seasons of winter virus release to know a little better.” Colored transmission electron micrograph showing influenza virus particles. Surface proteins on virus particles are shown in black. (National Institute of Allergy and Infectious Diseases (NIAID)) Viruses known to cause the common cold tend to circulate at different times than the flu, he continued, while COVID has emerged during the winter, times when the flu would normally circulate in Canada. “That’s the concern: What will these two viruses do when they’re released at the same time?” Kelvin asked.
Expecting a ‘really busy flu season’
Dr. Alison McGuire, an infectious disease specialist with Sinai Health System in Toronto, is among those preparing for that possibility. “If we were just looking at COVID going into the fall, I think that would be fine,” he said. “The problem is, what we’re looking forward to is a really busy flu season.” But there’s also a chance this year could just be marked by the return of the flu, not a significant increase in COVID, Gardam said. More indoor socializing or the arrival of another more contagious or immune-evasive strain could certainly increase the number of COVID cases. At the same time, Gardam noted that Canada already experienced a surge in late summer, thanks to the rapid spread of BA.5, Omicron’s latest subvariant to take place. “If we don’t see another variant emerge, those of us who have been infected with COVID and have been vaccinated, we’re pretty good for the next few months,” he continued. “So maybe the fall will be quiet.” WATCHES | Why it took so long for the flu to return to Canada:
Flu season is unusually late to hit Canada
Experts believe the lifting of public health restrictions may be responsible for the rise in flu cases across the country, adding pressure to hospitals already under pressure from the sixth wave of the pandemic.
Pandemic precautions still serve a purpose
A quiet decline overall would be an ideal scenario, given the problems already plaguing Canada’s health care system, from family physician shortages, long wait times in emergency departments, to high levels of hospital patients stuck waiting for alternatives like home or for a long time. -chronic care. But experts say that’s also unlikely. “The combination of the state our health care system is in, the fact that we’re going to continue to have COVID, the fact that we want to catch up on all the surgeries and other things that we have back — and the busy flu season — is going to make it very difficult,” McGeer warned. Scientists and medical experts CBC News spoke to agreed that there will be some level of circulation of multiple viruses, possibly overlapping at different points in the fall and winter. At the very least, it could disrupt people’s lives and cause absenteeism in a wide variety of areas — including health care itself. It also makes it harder to know which virus you have, with so many similarities between cold, flu and COVID symptoms. “It’s a little bit different now to expect people to be able to interpret their situation and do what’s right for them than it was three years ago,” McGeer said. Even so, he said time-tested pandemic protections still apply, including being informed about vaccinations, isolating when sick and getting a COVID test. A COVID-19 vaccination clinic at the Vancouver Convention Center on January 13, 2022. (Ben Nelms/CBC) On the prevention side, it’s worth getting both an annual flu shot and a COVID booster, several experts agreed. Specifically, the bivalent COVID vaccines expected to arrive this fall for adults — which target both the original SARS-CoV-2 and members of the Omicron family — may reclaim some protection vaccines offered a year ago, the which were later lost as new variants learned how to better evade our immune systems, Gardam said. If you do get a bug and aren’t sure what it is, McGeer said it’s worth taking time off work, if possible, and getting tested for COVID. “Rapid tests are really useful to understand … what’s causing your symptoms and what to do,” he added. Then, barring any change in government policies this fall, it will be up to individuals to figure out their next steps.
When to isolate
Health care workers in close contact with patients should continue to isolate at home if possible regardless of their test results, McGeer said, along with anyone who tests positive for COVID. People in any role who test negative should still consider themselves contagious with some kind of virus – and take measures to mitigate transmission, which could mean skipping social events, working from home and wearing a mask if working alone in the office or while running essential tasks. Those pandemic principles are worth pursuing, Kelvin said, since COVID isn’t the only pathogen that can have a negative impact. WATCHES | WHO reports more than 1 million deaths from COVID in 2022 so far:
More than 1 million dead from COVID-19 so far in 2022: WHO
WHO’s technical lead for COVID-19, Maria Van Kerkhove, said it was “alarming” and “tragic” that more than 1 million people had died from COVID-19 this year. Expect more hospitalizations and more deaths as the virus spreads around the world. “Flu is a serious illness … so if you have flu-like symptoms that can also be confused with COVID-19, you should self-isolate.” If Canada faces a difficult fall and winter and infections from multiple pathogens begin to take a heavy toll on the health care system, Gardam said it would be worth returning to extensive public health measures. “If it looks like we’re having problems, I would personally recommend asking people to cover the indoor areas,” he said. “This isn’t remotely a lockdown right? I don’t think anyone wants to go back into a lockdown again, but simple things like wearing a mask, honestly, I don’t think it’s that big of a deal.”
